Jul 06

Hearing Voices: What happens in the brain during auditory hallucinations?

Radio National on 22nd July 2006 had a seg­ment on the program "All in the Mind" on hearing voices. Lynne Malcolm from All in the Mind spoke with: Ron Coleman and Lyn Ma­hboub who hear voices as well as Professor David Copolov from Monash University who did a large study into the cause and treat­ment of auditory hallucinations (or hearing voices).

The program covered information about what happens in the brain during auditory halluci­nations, different types of voices and per­sonal experiences of hearing voices, treatments including pharmacological treatment and psychological strategies, as well as infor­mation about the "Hearing Voices Network".

What happens in the brain during auditory hallucinations?

According to Prof Copolov, two areas of the brain have been found to be active during auditory hallucinations: The temporal lobes (which are involved in processing normal sounds); and the hippocampus (which is in­volved with processing of memory). One the­ory about some auditory hallucinations is that they are to do with "a combination of reacti­vation of memories" (of things people have said to the person who hears the voice)'"with the false perception of external or internal voices". Also the fact that the temporal lobes are active shows why the voices are so real to the person and it is "as if this part of the brain is being tricked" into thinking there is a voice. According to Prof Copolov, it may be in some ways like "phantom limb syndrome" when someone has a leg or arm amputated and still has the sensation of having a leg or arm.

What are the different types of voices?

According to Lynne Malcolm it's thought that 10% of people experience some form of hearing voices that aren't there. The types of voices that are associated with psychiatric illness, however, can be very "frequent, intru­sive and painfully real and can severely dis­rupt people's lives". The types of voices are very varied though some types have classified including "command voices" which command the person to do something.

Personal experiences of hearing voices.

“Lyn Mahboub described her voices as “negative dribble in the background”.

Ron Coleman de­scribed having six or seven different voices. He explained that he hears the voices externally not in his head. He described his experience initially as "the voices are so in­tense and they always pick on the bits of us that are our weaknesses. They leave us feel­ing as if we are worthless and hopeless and we become victims of that". He gave an ex­ample of a voice he heard of his first partner who had died telling him to kill himself so they could be a family again. He said he "broke down totally". However, later as he found ways of coping with voices Ron was able to do things he wanted in his life like get married and have children and he describes that he "was able to take control over the voices.

Lyn Mahboub described her voices as "negative dribble in the background". She said "I call it the interpreter that sort of interprets a lot of the inter­actions that I might have with people".

Treatments

Pharmacological treatments

According to Prof Copolov “there is no doubt that the most effective treatment for psychotic symptoms including hallucinations is anti-psychotic medication. Although in about 25% of the people with hallucinations that are as a result of a psychotic disorder, that medication isn't go­ing to reduce the voices to a sufficient level".

Psychological strategies

Ron and Lyn. both described their positive experience of self-help support groups such as the Hearing Voices Network where they could talk to others who heard voices and learn from their experiences and develop their own coping strategies. For example, be­ing told that the voices were real was a turn­ing point for Ron.

Prof Copeloy spoke of the importance of talk­ing about the voices and a good relationship with a therapist. He described some strate­gies used in a clinic in Melbourne for people who are distressed by voices. For example, one approach is working to help people to understand that no harm will come to them if they don't follow command hallucinations.

Lyn described coping strategies that she and others she knows use. For example, she said that people might have "structured time tech­niques, which is whereby you will listen to the voices at a particular time throughout the day and then you ask them to leave you alone at the rest of the day so that you can go to work and do various other activities". She also describes "voice dialogue", which is where "another voice hearer, or a worker, will sit and actually have a conversation

The Hearing Voices Network

"This Network was initiated by a Dutch psychiatrist, Marius Romme, in the early 90s" who "was convinced that validation of the voice hearer's experience and support from others can play a crucial role in people's recovery". The Hearing Voices Network is well established in the UK and is starting to be established in Australia. You can contact the Australian Hearing Voices Network through the Richmond Fel­lowship in Western Australia. www.rfwa.org.au

This information is from the transcript of the programme: http://www.abc.net.au/rn/allinthemind/stories/2006/1689941.htm

If you hear voices and want to share your coping strategies with others or just explain what it is like for you, you can write to NSW CAG and we can put it in the next issue of INFO_LINK.

Yvette Cotton